EATING WELL

EATING WELL; Cow's Milk And Children: A New No-No?

By MARIAN BURROS

Published: September 30, 1992

THE Physicians Committee on Responsible Medicine, whose interests include both preventive medicine and alternatives to animal research, has declared war on that great American icon milk. "Parents," the committee said in a statement released in Boston yesterday, "should be alerted to the potential risks to their children from cow's-milk products." It added, "Milk should not be required or recommended in Government guidelines."

But while many pediatric experts say that cow's milk should not be given to infants, they strongly disagree with some of the committee's recommendations.

"The major problem with their position," said Dr. Ronald Kleinman, chairman of the American Academy of Pediatrics committee on nutrition, "is that they are unnecessarily frightening parents who worry that they will do harm if they continue to allow their children to have dairy products. There is no single perfect food, but milk is a major source of a number of important nutrients."

The committee asserted yesterday that milk is an unhealthful food because it has too much fat, produces iron deficiency in infants, causes diabetes in children with the genetic predisposition to the disease and is responsible for colic, allergies and digestive problems.

The presence of Dr. Benjamin Spock on the panel at the news conference appeared to lend weight to the committee's contentions and recommendations. But in a telephone interview yesterday, Dr. Spock made it clear that he agreed only that breast-feeding is the preferred method of infant feeding and that whole milk from cows should not be given to infants under a year old because of the risk of anemia.

"I won't say, 'Don't drink milk,' " said the 89-year-old Dr. Spock, who through his book "Baby and Child Care" has helped millions of American parents raise their children. "There is evidence accumulating that it is not good for infants."

The Physicians Committee, based in Washington, has carried that word of caution many steps further. "Milk," said Dr. Neal D. Barnard, committee's director, "is a perfect food for calves and is well tolerated by some Caucasians, but for others it's a problem. I don't recommend milk for anyone."

There is no argument that milk, with the exception of skim varieties, is high in fat and very low in iron. It is also known to cause allergies, and diarrhea and gas in people who are lactose intolerant.

The big question, and the main one on which the committee is basing its warning, is whether cow's milk contributes to juvenile diabetes. A Finnish study, reported in the July 30 issue of The New England Journal of Medicine, suggests that in many cases juvenile diabetes may be triggered by an immune-system response to proteins in cow's milk in infants.

Dr. Barnard called this study proof of the link, but Sara King, the research director of the Juvenile Diabetes Foundation, said, "It is much too premature to make recommendations on dietary restrictions." Ms. King said she was "very uncomfortable taking a stand against dairy products for young children."

But others agree, at least partly, with Dr. Barnard's position that cows milk is not good for humans. Dr. Frank Oski, director of the department of pediatrics at the Johns Hopkins University School of Medicine said, "There is no redeeming feature to cow's milk that should make people drink it." But he added: "It is relatively safe to drink milk after about a year or a year and a half. It's not going to kill you."

Suzanne Havala, a registered dietitian from North Carolina, who was a co-author of the American Dietetic Association's position paper on vegetarian diets, supports the recommendations. "After weaning, there is no need for milk of any sort in the diet in any species," she said. Vegetarians get all the calcium they need from leafy vegetables, broccoli, tahini and tofu made with calcium sulfate.

Dr. Kleinman agrees but says it unrealistic to expect Americans to follow such a diet. "Can children grow without milk?" he said. "Yes. But most children are not vegetarians and most parents are not vegetarians and they don't have the expertise to follow a vegetarian diet."

Perhaps the most scathing criticism of the physicians' committee came from the Center for Science in the Public Interest, a consumer advocacy group in Washington and itself once considered out of the mainstream. Bonnie Liebman, the center's director of nutrition, said, "I fear the committee's dietary advice is influenced by its animal-rights agenda."

Dr. Barnard acknowledged that his group's position was radical enough to upset people. "The idea of not giving milk to children sounds to people like child abuse," he said.